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肺部超声检查在急诊科收治的COVID-19患者诊断中的作用。

Role of lung ultrasonography in the diagnosis of COVID-19 patients admitted to the emergency department.

作者信息

Şan İshak, Bekgöz Burak, Usul Eren, Yıldırım Çağdaş, Gemcioğlu Emin, Kahraman Ahmet Fatih, Ay Ahmet Emre

机构信息

Ankara, Turkey Faculty of Medicine, Department of Emergency Medicine, University of Health Sciences.

Department of Emergency Medicine, Ankara City Hospital, Ankara, Turkey.

出版信息

Notf Rett Med. 2021;24(Suppl 1):15-20. doi: 10.1007/s10049-020-00807-3. Epub 2020 Dec 2.

Abstract

INTRODUCTION

In this study, the use of lung ultrasonography (LUS) to diagnosis lung findings was evaluated in patients with suspected COVID-19 who were admitted to the emergency department (ED).

METHODS

This observational clinical study was conducted in the ED of the Ankara City Hospital during the period April 1-30, 2020. Patients who were admitted to the ED were triaged as COVID-19 infected and who agreed to undergo LUS/LCT (lung computed tomography) were included in the study.

RESULTS

Included in the study were 40 patients who had been prediagnosed with COVID-19. Pneumonia was detected with LCT in 32 (80%) patients, while the LUS examination identified pneumonia in 23 patients. The most common finding in LCT was ground-glass opacity ( = 29, 90.6%). Of the 23 patients with pneumonia findings in LUS, 15 (65.2%) had direct consolidation. Among the 32 patients who were found to have pneumonia as a result of LCT, 20 (62.5%) had signs of pneumonia on LUS examination, and 12 had no signs of pneumonia. In addition, 3 patients showed no signs of pneumonia with LCT, but they were misdiagnosed with pneumonia by LUS. The sensitivity of LUS in the diagnosis of pneumonia in the COVID-19 patients was 62.5%, while its specificity was 62.5%. In addition, its positive predictive value was 87.0%, and its negative predictive value was 29.4%.

CONCLUSION

LUS may also be used in the diagnosis of pneumonia in COVID-19 patients because it is a valuable and accessible bedside diagnostic tool.

摘要

引言

在本研究中,对因疑似新型冠状病毒肺炎(COVID-19)而入住急诊科(ED)的患者使用肺部超声(LUS)诊断肺部病变情况进行了评估。

方法

本观察性临床研究于2020年4月1日至30日在安卡拉市医院急诊科开展。入住急诊科且被分诊为感染COVID-19并同意接受LUS/肺部计算机断层扫描(LCT)的患者被纳入研究。

结果

本研究纳入了40例预先诊断为COVID-19的患者。LCT检测出32例(80%)患者患有肺炎,而LUS检查发现23例患者患有肺炎。LCT最常见的表现是磨玻璃影(n = 29,90.6%)。在LUS检查发现有肺炎表现的23例患者中,15例(65.2%)有实变。在LCT检查发现患有肺炎的32例患者中,20例(62.5%)在LUS检查时有肺炎体征,12例无肺炎体征。此外,3例患者LCT检查无肺炎体征,但LUS检查误诊为肺炎。LUS对COVID-19患者肺炎诊断的敏感性为62.5%,特异性为62.5%。此外,其阳性预测值为87.0%,阴性预测值为29.4%。

结论

LUS可能也可用于COVID-19患者肺炎的诊断,因为它是一种有价值且可在床边使用的诊断工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9471/7709804/b1adb79d4179/10049_2020_807_Fig1_HTML.jpg

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